CAJ | 학술논문

目的评价i-gel喉罩用于腹腔镜胆囊手术患者气道管理的效果.方法择期全麻下拟行腹腔镜胆囊手术患者120例,性别不限,ASA分级Ⅰ或Ⅱ级,年龄34～62岁,体重45～90 kg,随机分为2组(n=60):ProSeal喉罩组(P组)和i-gel喉罩组(Ⅰ组).根据体重选择喉罩型号,麻醉诱导后置入喉罩,行机械通气,并经引流管放置胃管.记录喉罩置入次数、喉罩及胃管置入情况、纤支镜检查评分,测定喉罩密封压,观察术中口咽部漏气、低氧血症的发生情况.术中监测SpO2、PETCO2、气道峰压,观察拔除喉罩后恶心、呕吐、呛咳、声嘶、咽喉痛、返流误吸的发生情况,记录麻醉时间、手术时间、拔除喉罩时间及苏醒时间.结果两组麻醉时间、手术时间、拔除喉罩时间及苏醒时间差异无统计学意义(P＞0.05).两组术中SpO2、PETCO2、气道峰压均在正常范围内.与P组比较,Ⅰ组喉罩首次置入成功率和纤支镜检查评分升高,喉罩置入时间缩短(P＜0.05).两组喉罩和胃管置入成功率均为100%;Ⅰ组和P组喉罩密封压比较差异无统计学意义(P＞0.05);Ⅰ组咽喉痛发生率低于P组(P＜0.05),恶心呕吐、呛咳发生率差异无统计学意义(P＞0.05),两组无一例发生声嘶、返流误吸.结论 i-gel喉罩易于置入,气道密封性可靠,通气效果好,不良反应少,可安全有效地用于腹腔镜胆囊手术患者的气道管理.
목적 평개i-gel후조용우복강경담낭수술환자기도관리적효과.방법 택기전마하의행복강경담낭수술환자120례,성별불한,ASA분급Ⅰ혹Ⅱ급,년령34～62세,체중45～90 kg,수궤분위2조(n=60):ProSeal후조조(P조)화i-gel후조조(Ⅰ조).근거체중선택후조형호,마취유도후치입후조,행궤계통기,병경인류관방치위관.기록후조치입차수、후조급위관치입정황、섬지경검사평분,측정후조밀봉압,관찰술중구인부루기、저양혈증적발생정황.술중감측SpO2、PETCO2、기도봉압,관찰발제후조후악심、구토、창해、성시、인후통、반류오흡적발생정황,기록마취시간、수술시간、발제후조시간급소성시간.결과 량조마취시간、수술시간、발제후조시간급소성시간차이무통계학의의(P＞0.05).량조술중SpO2、PETCO2、기도봉압균재정상범위내.여P조비교,Ⅰ조후조수차치입성공솔화섬지경검사평분승고,후조치입시간축단(P＜0.05).량조후조화위관치입성공솔균위100%;Ⅰ조화P조후조밀봉압비교차이무통계학의의(P＞0.05);Ⅰ조인후통발생솔저우P조(P＜0.05),악심구토、창해발생솔차이무통계학의의(P＞0.05),량조무일례발생성시、반류오흡.결론 i-gel후조역우치입,기도밀봉성가고,통기효과호,불량반응소,가안전유효지용우복강경담낭수술환자적기도관리.
Objective To assess the efficacy of the laryngeal mask airway i-gel (LMA i-gel) in patients umdergoing laparoscopic cholecystectomy. Methods One hundred and twenty ASA Ⅰ or Ⅱ patients of both sexes,aged 34-62 yr, weighing 45-90 kg, undergoing elective cholecystectomy using fiberoptic laparoscope, were randomized into 2 groups (n =60 each): LMA i-gel group (group I) and LMA ProSeal group (group P). After induction of anesthesia with sufentanil 0.2 μg/kg, propofol 2.5 mg/kg and vecuronium 0.1 mg/kg, LMA i-gel and LMA ProSeal were inserted in group I and P respectively. A gastric tube was inserted through the drain tube of the LMAs. The number of attempts, success rate, success rate of gastric tube placement, airway seal pressure, SpO2 ,PETCO2, peak airway pressure and complications (hypoxemia, nausea and vomiting, choking hoarseness, sore throat and regurgitation of gastric contents) were recorded. The fiberoptic laryngoscope scores were assessed after sccessful LMA placement. The anesthesia time, duration of surgery, extubation time and emergence time were also recorded. Results There was no significant difference in the anesthesia time, duration of surgery, extubation time and emergence time between the two groups ( P ＞ 0.05). The SpO2, PETCO2 and peak airway pressure were within the normal range during operation in both groups. The first attempt success rate of LMA placement and fiberoptic bronchoscopic scores were significantly higher, and the LMA placement time was significantly shorter in group Ⅰ than in group P (P ＜ 0.05). The success rate of LMA and gastric tube placement was 100% in both groups. The incidence of sore throat was significantly lower in group I than in group P ( P ＜ 0.05). Conclusion LMA i-gel can provide adequate ventilation during operation with less complications and can be used effectively for cholecystic laparoscopic surgery.